A national report card released last month gave Hawaii an F for disaster preparedness, but the head of a little-known, statewide mobile hospital system says the grade was unfair.

"They didn’t look at the contingency resources that are available; they only looked at the day-to-day resources. They only looked at what is, not what could be," said Toby Clairmont, director of the Healthcare Association of Hawaii Emergency Services.

The report card issued by the American College of Emergency Physicians cited the closure of the Hawaii Medical Centers in Liliha and Ewa in 2011 as a key reason for the state’s failing grade.

What they didn’t take into account, according to Clairmont, is Hawaii’s 750-bed mobile hospital tucked away in unmarked containers, warehouses and a tunnel.

A team of 1,200 emergency responders — including doctors, nurses, pharmacy workers and laboratory technicians — can assemble $10 million worth of medical supplies and equipment within four hours to respond to a disaster.

Think of it as a high-tech version of the mobile Army surgical hospital depicted in the 1970s television series "M*A*S*H."

In addition to the 750 hospital beds, there are 1,000 cots, 4,500 meals in self-heating packets, 4,500 bottles of water and 300 different types of medication in a portable pharmacy.

HAH Emergency Services Coalition, a division of the Healthcare Association of Hawaii, which advocates on behalf of hospitals and nursing facilities, has coordinated hospital emergency response teams with $1.4 million in federal grants a year since the Sept. 11, 2011, terrorist attacks.

But now its sole source of funding is set to be cut by 30 percent starting July 1, following a decision by the Obama administration to appropriate money for the U.S. Department of Health and Human Services Hospital Preparedness Program to higher-priority areas.

Hawaii’s disaster preparedness program will take a hit of $408,000 a year, threatening its ability to operate the mobile hospital and restock its shelves once medical supplies and medications expire, Clairmont said.

"If we were (on the mainland), resources can move interstate. We have what we have. We have to increase our self-sufficiency in order to cope with that," he said. "A cut of 30 percent to, say, Colorado or California is manageable because they can count on other states’ support. A cut to Hawaii means something is no longer here, and that’s a problem."

The mobile hospital composed of aluminum frame structures with a special plastic coating is set up during high-profile events such as the Asia-Pacific Economic Cooperation in 2011.

The group also gets involved locally during power and water outages and labor strikes, and even maintains the information system that routes ambulances. In addition, the team helps in U.S. Coast Guard rescues involving critical-care patients.

Locally, the group most recently responded to the 2006 earthquake in Kiholo on Hawaii island, which forced the evacuation of Kona Community Hospital. Patients were transferred to the mobile hospital set up in the parking lot.

The team also travels to disasters around the country, lugging medical supplies and equipment that includes four biocontainment chambers used to isolate infectious-disease patients. They have responded to crises in American Samoa following a 2009 earthquake and relief efforts after Hurricane Sandy in New York in 2012, Hurricane Katrina in New Orleans in 2005 and the 2001 terrorist attacks in New York City.

The bulk of its emergency equipment, including an anthrax decontamination system built specifically for APEC, is housed in a climate-controlled warehouse in Halawa.

The nondescript building with no permanent signage stores millions of dollars in pharmaceuticals and medical supplies, containers for corpses and components for the mobile hospital. Other parts of the mobile hospital are stored on Maui, Kauai and Hawaii island.

The Halawa facility includes a high-tech emergency operating center similar to the White House’s "situation room," complete with video equipment connected to the city’s Emergency Medical Services ambulance system, Hawaii State Civil Defense and U.S. Coast Guard.

The group is currently able to operate uninterrupted for seven days, the estimated time it would take for federal responders 2,500 miles away to bring aid to the islands in an emergency, Clairmont said.

"We know it’s going to take that long for the cavalry to come, so we have to bridge that gap," he said. "Until a disaster occurs or you get the bill, you don’t pay much attention to how that happens. Today the bill has come in. The reality is we probably don’t have enough money to pay for what we have right now, so we’re going to have to reduce what we do to compensate for it."

That means providing fewer services to stretch resources. The nonprofit Healthcare Association of Hawaii Emergency Services spends a quarter of its budget each year replacing drugs and medical supplies that have strict expiration dates.

With the budget cuts coming July 1, Clairmont said, "There won’t be money to replace equipment as it ages out."

The offices of U.S. Sens. Brian Schatz and Mazie Hirono said the senators could not have prevented the across-the-board budget cuts for emergency preparedness that were made by the Obama administration based on a formula.

"Hawaii was not singled out. Funding will be equally reduced among all the states as the administration is working to move the program toward regional networks," said Meaghan Smith, a Schatz spokeswoman. "Sen. Schatz wants to ensure Hawaii has every emergency resource the state needs, so if HAH does see a funding reduction … we will work with them on funding in next year’s appropriations process. Continuing to ensure that the people of Hawaii are protected in an emergency is Sen. Schatz’s priority."

Sabrina Siddiqui, spokeswoman for Hirono, said that Healthcare Association of Hawaii officials had not previously raised the concern with the delegation, which plans to work with the organization if the cuts become an issue.

Hospitals and other medical providers internally fund their participation in the program.

Over the past decade, the number of participating organizations has increased to about 130 from 29, including 30 hospitals, community health centers, nursing facilties, care homes, blood banks, laboratories and air ambulances.